Provider Demographics
NPI:1821094335
Name:NAINI, GNANA SUMATHI REDDY (MD)
Entity Type:Individual
Prefix:
First Name:GNANA SUMATHI
Middle Name:REDDY
Last Name:NAINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5835
Mailing Address - Country:US
Mailing Address - Phone:469-936-0541
Mailing Address - Fax:877-541-4239
Practice Address - Street 1:1205 NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5835
Practice Address - Country:US
Practice Address - Phone:469-936-0541
Practice Address - Fax:877-541-4239
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6902207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122865503Medicaid
TX122865503Medicaid